Chapter 4, Food and Nutrients to Increase

Individuals should meet the following recommendations as part of a healthy eating pattern and while staying within their calorie needs.

Increase vegetable and fruit intake.

Eat a variety of vegetables, especially dark green, red and orange vegetables and beans and peas.

Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.

Increase intake of fat-free or low-fat milk and milk products.

Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans, peas, soy products, and unsalted nuts and seeds.

Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry.

Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils.

Use healthy oils to replace solid fats where possible.

Choose foods that provide more potassium, dietary fiber, calcium and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains and milk products.

Key recommendations for women capable of becoming pregnant

Choose foods that supplement heme iron, which is more readily absorbed by the body, additional iron sources and enhancers of iron absorption such as vitamin C-rich foods.

Most vegetables and fruits are major contributors of a number of nutrients that are underconsumed in the U.S.

Consumption of vegetables and fruits is associated with reduced risk of many chronic diseases. Some fruits and vegetables may be protective against certain types of cancer.

Most vegetables and fruits when prepared without added fats or sugars are relatively low in calories. Eating fruits and vegetables instead of higher-calorie foods can help adults and children achieve and maintain a healthy weight

Grains Most Americans eat enough total grains in a day, but most grains consumed are refined and not whole grains.Whole grains include the entire grain seed or kernel. Whole grains are consumed either as a single food or as an ingredient in foods. In refined grains, dietary fiber, iron and many B vitamins are removed. Enriched grains are grains in which B vitamins and iron are added. Most refined grains are enriched grains.

Americans should aim to replace many refined grain foods with whole grain foods that are in their nutrient-dense forms to keep total calorie intake within guidelines.

The amount of whole grain in a product can be determined by the placement of the grain in the ingredient list. Whole grain should be the first or second ingredient listed.

Half of your grains per day should be whole grains.

Milk and Milk Products contribute nutrients such as calcium, vitamin D, and potassium to the diet. Today the majority of milk and milk products consumed by Americans comes from 2% and whole milk. About half of dairy products consumed comes from cheese. Choosing fat-free or low-fat milk and milk products provides the same nutrients with less solid fat and fewer calories. It is important to establish milk drinking in young children because those children are more likely to continue drinking milk as an adult.

Other nutrients of concern for specific groups include iron, folate and vitamin B12

What Are The Dietary Guidelines?

The Dietary Guidelines for Americans, 2010 target Americans ages 2 years and older, including those who are at increased risk of chronic disease. The Dietary Guidelines are reviewed, updated and published every five years through the joint efforts of U.S. Department of Health and Human Services (DHHS) and the United States Department of Agriculture (USDA).

Following the Dietary Guidelines on a regular basis can help reduce the risk of chronic disease and obesity. A basic idea of the Dietary Guidelines is that nutrient needs should be met primarily through consuming food. Americans should try to consume a diet that achieves the Institute of Medicine’s most recent Dietary Reference Intakes (DRIs), which consider a person’s life stage, gender and activity level. Another important idea is that food should be handled and prepared carefully to reduce the risk of foodborne illnesses also known as food poisoning.

The 2010 Dietary Guidelines developed for Americans include 6 chapters:

1. Introduction

2. Balancing Calories to Manage Weight

3. Food and Food Components to Reduce

4. Food and Nutrients to Increase

5. Building Healthy Eating Patterns

6. Helping Americans Make Better Choices

In addition, the Dietary Guidelines have 23 key recommendations for the general population and six recommendations for specific population groups.

Basic Premises Of The Dietary Guidelines

The Dietary Guidelines promote:

Reducing the risk of chronic disease and obesity.

Meeting nutrient needs primarily through food.

Preparing and handling food to reduce risk of foodborne illness.

Diets that provide all the nutrients needed for growth and health recommended by the Institute of Medicine’s Dietary Reference Intakes (DRIs).

* Note that the DRIs are the nutrients recommended for humans to function at an optimal level and include nutrients such as vitamin C, protein, calcium, etc. and the amounts they should consume at different ages.

The term DRIs can be considered an “umbrella term” and actually includes other dietary guidance documents, such as the Recommended DietaryAllowances (RDA), which are used on food labels, and the Adequate Intakes (AI).

2010 Dietary Guidelines Differ From Previous Versions

The Dietary Guidelines have previously been intended for healthy Americans age 2 years old and older. However, Dietary Guidelines, 2010 are being released at a time of rising concern about the health of the American population. Its recommendations accommodate the reality and concern that a large percentage of Americans are overweight or obese and/or are at risk of various chronic diseases.

Eating Patterns Show How To Eat In Accordance With the Dietary Guidelines

USDA Food Guide and DASH Eating Plan – These are two examples of eating plans based on the Dietary Guidelines. The two eating plans show how to choose foods to get the nutrients needed each day, which are listed in the Dietary Reference Intakes. Food guides may be illustrated by graphic designs and provide an easy way to get the nutrients you need. Rather than having to count up the number of milligrams or micrograms of each nutrient you need, eating the recommended servings of foods from the food guide will provide the needed nutrients.

USDA Food Guide – number of servings and amounts of food to consume from basic food groups to meet recommended nutrient intakes at 12 different calorie levels.

DASH Eating Plan – Originally developed to study the effects of diet on preventing hypertension, it shows the number of servings and amounts of food to consume to meet recommended nutrient intakes at four different calorie levels.

The USDA Food Guide and the DASH diet provide the recommended nutrients established by the Institute of Medicine’s Dietary Reference Intakes (DRIs). The DRIs include the Recommended Dietary Allowances (RDA) and the Adequate Intakes (AI). The Dietary Reference Intakes are the nutrients recommended for humans, such as vitamin C, protein, calcium, etc. and the amounts they should consume at different ages.

The Nutrition Facts provide information about nutrients in foods. Two thousand calories is the value used as a general reference on the food label. You can calculate your number at www.healthierus.gov/dietaryguidelines.

Chapter 1, Introduction

It is important to consume a variety of nutrient-dense foods and beverages within and among the basic food groups while choosing foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt and alcohol. Additionally, it is important to meet recommended intakes within energy needs by adopting a balanced eating pattern, such as the U.S. Department of Agriculture (USDA) Food Guide or the Dietary Approaches to Stop Hypertension (DASH) Eating Plan.

Chapter 2, Balancing Calories to Manage Weight

This section explains calorie balance, describes some of the environmental factors that have contributed to the current epidemic of overweight and obesity, and discusses diet and physical activity that can be used to help Americans achieve calorie balance.

Calorie balance over time is key to managing weight. This is the relationship between calories consumed through food and beverages and calories expended through body functions and physical activity every day. Calories eaten must equal calories burned to maintain the same body weight.

The current dietary intake of Americans has contributed greatly to the obesity epidemic.

Calorie Balance: Food and Beverage Intake

Total number of calories a person needs each day varies depending of factors, such as age, gender, height, weight and level of physical activity.

Carbohydrates, protein, fat and alcohol are the main sources of calories in the diet.

Carbohydrates contribute four calories per gram and are the primary source of calories for most Americans, mainly through consumption of starches (grains, potatoes and starchy vegetables). Most Americans consume too much added sugar and refined grains and not enough fiber.

Protein also provides four calories per gram. They have amino acids that assist in building and preserving body muscle. Animal-based protein includes meat, poultry, eggs and milk products. Plant protein sources include beans, peas, seeds and soy products.

Fats provide nine calories per gram. Inadequate daily fat intake is rare in the United States. Americans usually consume too many trans fat and saturated fat and not enough unsaturated fat.

Physical activity is one side of the calorie balance equation. Decreasing time spent being sedentary is important. Regular physical activity has been shown to help people maintain healthy body weights and prevent weight gain.

Prepare, serve and consume smaller portions of foods and beverages, especially those high in calories.

Eat a nutrient-dense breakfast.

Limit screen time.

Chapter 3, Food and Food Components to Reduce

Key Recommendations

Reduce daily sodium intake to less than 2,300 mg and further reduce intake to 1,500 mg among persons who are 51 years old and older and those of any age who are African-American or have hypertension, diabetes or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children, and the majority of adults.

Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.

Consume less than 300 mg per day of dietary cholesterol.

Keep trans fatty acid consumption as low as possible, especially by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.

If alcohol is consumed, it should be consumed in moderation – up to one drink a day for women and two drinks a day for men – and only by adults of legal drinking age.

Supporting the Recommendations for Sodium:

Sodium: Sodium is needed by the body in small quantities. Most of the time the higher the individual's sodium intake, the higher the blood pressure. Most sodium intake comes from the salt added during the processing of food. Processed foods are the main contributor of salt in the American diet.

Reducing sodium intake:

Read the Nutrition Facts Label.

Consume more fresh foods and less processed foods.

Eat more home prepared meals.

When eating out, ask that salt not be added to your food.

General population: The sodium recommendation is consuming less than 2,300 mg daily. One should decrease amount of sodium to 1,500 mg/day if over 51 years of age, if African-American, with chronic kidney disease or with hypertension.

Fats: Dietary fats are found in both plant and animal foods. Fats help in the absorption of fat-soluble vitamins (A,D,E,K). The different forms of fat include saturated fat, unsaturated fat, polyunsaturated fat, monounsaturated fat and trans fat.

Saturated fatty acids have no double bonds. Some examples of saturated fat are found in animal products such as milk, meat, coconut oils, hydrogenated shortening.

Monounsaturated fatty acids have one double bond. Plant sources that are rich in monounsaturated fats are nuts and vegetable oils that are liquid at room temperature. Some examples of oils that are rich in monounsaturated fat are canola oil and olive oil.

Polyunsaturated fatty acids have two or more double bonds and are categorized in two types; omega 3 and omega 6 fatty acids.

Trans fatty acids are not essential in the diet and intake needs to be kept as low as possible. Some common sources of trans fatty acids are hydrogenated or partially hydrogenated vegetable oils.

The type of fatty acid consumed is more important in influencing the risk of cardiovascular disease than is the total amount of fat in diet. Replace solid fat (lard and butter) with vegetable oils rich in monounsaturated and polyunsaturated fats and oils.

Cholesterol

The body uses cholesterol for biological and structural functions. The body produces enough cholesterol for these purposes. Cholesterol is found only in animal foods.

Consuming less than 200 mg/day of cholesterol may further help individuals at high risk of cardiovascular disease.

Solid Fats and Added Sugars

Solid Fats: Most fats that have a high percentage of saturated and/or trans fats are solid at room temperature. Solid fats contribute about 19 percent of total calories in American diets. Major sources of solid fats include grain-based desserts, pizza, regular cheese, sausage, franks, bacon and ribs. Reducing these sources of excess solid fats in the diet will result in reduced intake of saturated fatty acids, trans fatty acids and calories.

Added Sugars: Added sugars contribute an average of 16 percent of the total calories in the American diet. High fructose syrup, white sugar, brown sugar, corn syrup solids, raw sugar, malt syrup, maple syrup, pancake sweetener, honey and molasses are all common added sugars. Major sources of added sugars include soda, energy drinks, grain-based desserts, sugar-sweetened fruit drinks, dairy-based desserts and candy. Eating less added sugars will lower the calorie content of the diet and maintain nutrient adequacy.

Solid-fat and added-sugar consumption is a major concern today because together they contribute a huge portion of the calories consumed by Americans. On average 35 percent of calories or about 800 calories per day from solid fats and added sugars have no nutrients needed in the daily diet.

Tips on Reducing consumption of added sugars and solid fat

1. Focus on eating nutrient-dense forms of foods from all food groups.

2. Limit the amount of solid fat and added sugars when cooking or eating (trim fat from meat; use less butter).

Refined Grains: The refining process of whole grains results in loss of vitamins, minerals and dietary fiber. Most refined grains are enriched with iron, some B vitamins and folic acid before being used in foods. Enriched refined grains provide some vitamins and minerals, unlike adder sugars and solids fats.

Alcohol: In the U.S., about 50 percent of adults are regular drinkers. Moderate alcohol intake is defined as up to one drink per day for women and up to two drinks a day for men of legal drinking age, which is 21 in Louisiana.

Those who should not drink alcohol:

Individuals who can’t restrict their drinking to moderate levels.

Anyone younger than legal drinking age, 21 in Louisiana.

Women who are pregnant or who may become pregnant.

Individuals taking prescription or over-the-counter drugs that interact with alcohol.

Individuals with certain medical conditions. Check with your doctor.

Individuals who plan to drive or operate machinery that requires attention and judgment.

Chapter 5, Building Healthy Eating Patterns

Key Recommendations

Select an eating pattern that meets nutrient needs over time at an appropriate calorie level.

Account for all foods and beverages consumed and assess how they fit within a total healthy-eating pattern.

Follow food safety recommendations when preparing and eating foods to reduce the risk of foodborne illnesses.

Healthy Eating Patterns

DASH (Dietary Approaches to Stop Hypertension) Eating Pattern – The DASH diet emphasizes vegetables, fruits, and low-fat milk and milk products. The diet generally includes whole grains, poultry, seafood and nuts. Compared with a typical Americans diet, the DASH diet is lower in sodium, lower in consumption of red and processed meats, and also lower in sweets and sugary beverages. The DASH diet is very consistent with the Dietary Guidelines.

APPENDIX 10 – The DASH Eating Plan at various calorie levels.

Mediterranean-Style Eating Pattern – In general terms, Mediterranean-style eating is described as an eating pattern that emphasizes vegetables, fruits, nuts, olive oil and grains. And only small amounts of meats and full-fat milk and milk products are consumed.

Vegetarian Eating Pattern – Vegetarian-style eating patterns have been associated with improve health outcomes, including lower rates of obesity, reduced risk of cardiovascular disease and a lower rate of death. Vegetarians usually consume lower amounts of calories from fat and more fiber and potassium.

The USDA food patterns include daily amounts of foods to eat from the five major food groups and subgroups. Food patterns were made to meet nutrient needs like Dietary Reference Intakes (DRIs) and the Dietary Guidelines. You can refer to Appendix 5 in the Dietary Guidelines for information on DRIs. USDA food patterns have a selection of foods that are mostly in nutrient-dense form. This means that little or no solid fats and sugars have been added.

Following a healthy eating pattern should provide most of your daily nutrient needs. Healthy eating patterns promote a healthy lifestyle along with decreasing risk of chronic diseases.

The Goal of the Dietary Guidelines

The ultimate goal of the Dietary Guidelines, 2010 for Americans is to improve the health of our nation’s current and future generations by facilitating and promoting healthy eating and physical activity choices so that healthy behaviors become everyday habits among all individuals.

A growing body of scientific evidence demonstrates that the dietary and physical activity recommendations described in the Dietary Guidelines for Americans may help people attain and maintain a healthy weight, reduce the risk of chronic disease and promote overall health. These recommendations consider food preferences, cultural traditions and customs of the many and diverse groups of people that live in the United States.

The Dietary Guidelines are a summary of information about individual nutrients and food formed into a set of recommendations for healthy eating to be used by the general public.

Two Main Concepts of the Dietary Guidelines.

Maintain calorie balance over time to achieve and sustain a healthy weight.

Focus on consuming nutrient-dense foods and beverages, which means little or no solid fats and sugars are added.